Research project: Cold Atmospheric Plasma (CAP) for the decontamination of reusable surgical instruments

Currently Active:

Yes

Proteinaceous deposits remain on reusable surgical instruments following current decontamination processes. Also known as prions, the infectious proteins responsible for transmissible spongiform encephalopathies (TSEs) such as Creutzfeldt-Jakob disease (CJD) are particularly resilient. Using very sensitive fluorescent microscopy techniques, we are evaluating Cold Atmospheric Plasma as a new tool to remove all proteinaceous soiling from reusable surgical instruments and significantly reduce the risk of iatrogenic CJD.

Project Overview

The self-aggregating protease-resistant prion protein (PrPSc) plays a major role in transmissible spongiform encephalopathies (TSEs). Current decontamination techniques applied in sterile service departments (SSDs) of major hospitals or other healthcare facilities rely on enzymatic degradation followed by steam sterilization, to which PrPSc is particularly resilient, and there is evidence that iatrogenic transmission through reusable surgical instruments may occur during various surgical procedures.

The unknown prevalence of prion infection in the population following the appearance of variant Creutzfeldt-Jakob disease (vCJD) and the potential widespread distribution of PrPSc in tissues implies the need of developing new methods of decontamination to reduce significantly the threat of iatrogenic CJD. We propose to evaluate cold atmospheric plasma (CAP), a new technology which demonstrated the potential to achieve the required level of decontamination in preliminary evaluations.

To this effect we intend to combine very sensitive Episcopic Differential Interference Contrast / Epi-Fluorescence (EDIC/EF) microscopy to assess the amount of prion amyloid and other proteins present after CAP treatment of various spiked surfaces, and the well established model of intra-cranial implantation in susceptible animals to assess the action of CAP on PrPSc infectivity using the 263K scrapie strain.